Original Thoracic
Painful Chest Wall Swellings: Tietze Syndrome or Chest Wall Tumor? Tevfik Kaplan1 Nesimi Gunal2 Gultekin Gulbahar3 Bulent Kocer3 Serdar Han1 Mehmet Ali Eryazgan3 Arzu Ozsoy4 Seniha Naldoken5 Aslıhan Alhan6 Unal Sakinci3
Ankara, Turkey 2 Department of Thoracic Surgery, Kirikkale University School of Medicine, Kirikkale, Turkey 3 Department of Thoracic Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey 4 Department of Radiology, Ankara Numune Teaching and Research Hospital, Ankara, Turkey 5 Department of Nuclear Medicine, Ankara Numune Teaching And Research Hospital, Ankara, Turkey 6 Department of Statistics, Ufuk University Faculty of Arts and Science, Ankara, Turkey
Address for correspondence Tevfik Kaplan, MD, Department of Thoracic Surgery, Ufuk University School of Medicine, Dr. Rıdvan Ege Hastanesi, B Blok 6. kat Mevlana Bulvarı No: 66-68 (Konya Yolu) Balgat, Ankara, Çankaya 06520, Turkey (e-mail: tevfi[email protected]).
Thorac Cardiovasc Surg
Abstract
Keywords
► chest wall tumor ► computed tomography ► surgery ► bone scintigraphy
Objective Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction. Primary chest wall tumors may mimic TS. In this article, we report our experience of approximately 121 patients initially diagnosed as TS and determined chest wall tumor in some cases at the follow-up. Methods This is a retrospective review of patients diagnosed as TS by clinical examination, chest X-ray, electrocardiogram, routine laboratory tests, and computed tomography (CT) of chest: all treated and followed up between March 2001 and July 2012. There were 121 cases (41 males and 80 females; mean age, 39.6 3.2 years) of TS. Results In 27 patients with initial normal radiological findings, the size of swellings had doubled during the follow-up period (mean, 8.51 2.15 months). These patients were reevaluated with chest CT and bone scintigraphy and then early diagnostic biopsy was performed. Pathologic examination revealed primary chest wall tumor in 13 patients (5 malignant, 8 benign). CT had a sensitivity of 92.3% and a specificity of 64.2% in detection of tumors (kappa: 0.56, p ¼ 0.002), whereas the sensitivity and the specificity of bone scan were 84.6 and 35.7%, respectively (kappa: 0.199, p ¼ 0.385). Conclusion Primary chest wall tumors could mimic TS. Bone scintigraphy or CT is not specific enough to determine malignant and other benign disorders of costochondral junction. Therefore, clinicians should follow TS patients more closely, and in case of increasing size of swelling, early diagnostic biopsy should be considered.
Introduction Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction of
received July 10, 2014 accepted after revision December 9, 2014
unknown etiology. It usually occurs in younger adults (
Painful Chest Wall Swellings: Tietze Syndrome or Chest Wall Tumor? Tevfik Kaplan1 Nesimi Gunal2 Gultekin Gulbahar3 Bulent Kocer3 Serdar Han1 Mehmet Ali Eryazgan3 Arzu Ozsoy4 Seniha Naldoken5 Aslıhan Alhan6 Unal Sakinci3
Ankara, Turkey 2 Department of Thoracic Surgery, Kirikkale University School of Medicine, Kirikkale, Turkey 3 Department of Thoracic Surgery, Ankara Numune Teaching and Research Hospital, Ankara, Turkey 4 Department of Radiology, Ankara Numune Teaching and Research Hospital, Ankara, Turkey 5 Department of Nuclear Medicine, Ankara Numune Teaching And Research Hospital, Ankara, Turkey 6 Department of Statistics, Ufuk University Faculty of Arts and Science, Ankara, Turkey
Address for correspondence Tevfik Kaplan, MD, Department of Thoracic Surgery, Ufuk University School of Medicine, Dr. Rıdvan Ege Hastanesi, B Blok 6. kat Mevlana Bulvarı No: 66-68 (Konya Yolu) Balgat, Ankara, Çankaya 06520, Turkey (e-mail: tevfi[email protected]).
Thorac Cardiovasc Surg
Abstract
Keywords
► chest wall tumor ► computed tomography ► surgery ► bone scintigraphy
Objective Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction. Primary chest wall tumors may mimic TS. In this article, we report our experience of approximately 121 patients initially diagnosed as TS and determined chest wall tumor in some cases at the follow-up. Methods This is a retrospective review of patients diagnosed as TS by clinical examination, chest X-ray, electrocardiogram, routine laboratory tests, and computed tomography (CT) of chest: all treated and followed up between March 2001 and July 2012. There were 121 cases (41 males and 80 females; mean age, 39.6 3.2 years) of TS. Results In 27 patients with initial normal radiological findings, the size of swellings had doubled during the follow-up period (mean, 8.51 2.15 months). These patients were reevaluated with chest CT and bone scintigraphy and then early diagnostic biopsy was performed. Pathologic examination revealed primary chest wall tumor in 13 patients (5 malignant, 8 benign). CT had a sensitivity of 92.3% and a specificity of 64.2% in detection of tumors (kappa: 0.56, p ¼ 0.002), whereas the sensitivity and the specificity of bone scan were 84.6 and 35.7%, respectively (kappa: 0.199, p ¼ 0.385). Conclusion Primary chest wall tumors could mimic TS. Bone scintigraphy or CT is not specific enough to determine malignant and other benign disorders of costochondral junction. Therefore, clinicians should follow TS patients more closely, and in case of increasing size of swelling, early diagnostic biopsy should be considered.
Introduction Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction of
received July 10, 2014 accepted after revision December 9, 2014
unknown etiology. It usually occurs in younger adults (
